SARS-CoV-2 vaccine-induced humoral and cellular immunity in patients with hematologic malignancies

Haggenburg, Sabine; Hofsink, Quincy; Rutten, Caroline E.; Nijhof, Inger S.; Hazenberg, Mette D.; Goorhuis, Abraham

doi:10.1053/j.seminhematol.2022.11.001

Cited by 8 publications

(4 citation statements)

References 67 publications

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“…Furthermore, four of the six infected patients with indolent lymphoma who remained seronegative even after infection had mild disease. We speculate that repeated vaccination stimulates specific T-cell responses and activates cellular immunity, as reported by Uaprasert N et al [ 21 ] and Haggenburg S et al [ 33 ]. However, the Omicron strain is weakly virulent, so it cannot be ruled out that it may have been in a state of “immunological tolerance”.…”

Section: Discussionsupporting

confidence: 69%

Initial Efficacy of the COVID-19 mRNA Vaccine Booster and Subsequent Breakthrough Omicron Variant Infection in Patients with B-Cell Non-Hodgkin’s Lymphoma: A Single-Center Cohort Study

Saito,

Mori,

Ishio

et al. 2024

Viruses

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It has been suggested that the effect of coronavirus disease 2019 (COVID-19) booster vaccination in patients with B-cell non-Hodgkin’s lymphoma (B-NHL) is inferior to that in healthy individuals. However, differences according to histological subtype or treatment status are unclear. In addition, there has been less research on patients who subsequently develop breakthrough infections. We investigated the effects of the first COVID-19 booster vaccination for patients with B-NHL and the clinical features of breakthrough infections in the Omicron variant era. In this study, B-NHL was classified into two histological subtypes: aggressive lymphoma and indolent lymphoma. Next, patients were subdivided according to treatment with anticancer drugs at the start of the first vaccination. We also examined the clinical characteristics and outcomes of patients who had breakthrough infections after a booster vaccination. The booster effect of the COVID-19 mRNA vaccine in patients with B-NHL varied considerably depending on treatment status at the initial vaccination. In the patient group at more than 1 year after the last anticancer drug treatment, regardless of the histological subtype, the booster effect was comparable to that in the healthy control group. In contrast, the booster effect was significantly poorer in the other patient groups. However, of the 213 patients who received the booster vaccine, 22 patients (10.3%) were infected with COVID-19, and 18 patients (81.8%) had mild disease; these cases included the patients who remained seronegative. Thus, we believe that booster vaccinations may help in reducing the severity of Omicron variant COVID-19 infection in patients with B-NHL.

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Section: Discussionsupporting

confidence: 69%

Initial Efficacy of the COVID-19 mRNA Vaccine Booster and Subsequent Breakthrough Omicron Variant Infection in Patients with B-Cell Non-Hodgkin’s Lymphoma: A Single-Center Cohort Study

Saito,

Mori,

Ishio

et al. 2024

Viruses

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“…Patients with hematologic diseases are considered at particularly high risk for highly severe COVID‐19 disease, and although the humoral immune response to COVID‐19 vaccine and antibody titer increases are low, a significant cellular immune response is still observed. 16 If high antibody titers are maintained by hybrid immunization, additional vaccinations may induce adverse effects due to excessive immune responses such as VAHL. We must be cautious about such cases.…”

Section: Discussionmentioning

confidence: 99%

“…In general, individuals with underlying diseases are at a higher risk of developing high COVID‐19 severity; in such cases, additional positive vaccinations are recommended. Patients with hematologic diseases are considered at particularly high risk for highly severe COVID‐19 disease, and although the humoral immune response to COVID‐19 vaccine and antibody titer increases are low, a significant cellular immune response is still observed 16 . If high antibody titers are maintained by hybrid immunization, additional vaccinations may induce adverse effects due to excessive immune responses such as VAHL.…”

Section: Discussionmentioning

confidence: 99%

Increase in antibody titer and change over time associated with severe acute respiratory syndrome coronavirus 2 infection after mRNA vaccination: Consideration of the significance of additional vaccination

Kusunoki,

Ohkusa,

Iida

et al. 2024

Clinical Case Reports

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Key Clinical MessageMost Japanese patients naturally infected with COVID‐19 were infected after mRNA vaccination, and many maintained high antibody titers due to hybrid immunity. The significance of additional vaccination in hybrid‐immunized cases is highly questionable.AbstractSpontaneous infection with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) after mRNA vaccination causes a marked increase in antibody titer because of the combined effect of vaccine and infection (“hybrid immunity”). In this study, we discuss the significance of the mRNA vaccine booster inoculation that has been repeatedly performed in Japan. We describe the temporal trends of antibody titers in cases in which antibody titers were markedly increased by hybrid immunization. The antibody titer increased with hybrid immunization and tended to decrease with time. However, several cases maintained high antibody titers for approximately 1 year after coronavirus disease 2019 (COVID‐19) diagnosis, even without booster vaccination. Most Japanese patients naturally infected with COVID‐19 were infected after mRNA vaccination, and many maintained high antibody titers due to hybrid immunity. The significance of additional vaccination in hybrid‐immunized cases is highly questionable regarding cost‐effectiveness and risk–benefit.

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“…Additionally, in children with a history of SARS-CoV-2 infection, waning of the humoral immune response was seen in the 14 months following infection [34]. Therefore, future research is needed to optimize the booster schedule in children with cancer [36].…”

Section: Discussionmentioning

confidence: 99%

Immune Response following BNT162b2 mRNA COVID-19 Vaccination in Pediatric Cancer Patients

Schmidt

Dautzenberg

Hoogerbrugge

et al. 2023

Cancers

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COVID-19 vaccinations are recommended for children with cancer but data on their vaccination response is scarce. This study assesses the antibody and T-cell response following a 2- or 3-dose vaccination with BNT162b2 mRNA COVID-19 vaccine in children (5–17 years) with cancer. For the antibody response, participants with a serum concentration of anti-SARS-CoV-2 spike 1 antibodies of >300 binding antibody units per milliliter were classified as good responders. For the T-cell response, categorization was based on spike S1 specific interferon-gamma release with good responders having >200 milli-international units per milliliter. The patients were categorized as being treated with chemo/immunotherapy for less than 6 weeks (Tx < 6 weeks) or more than 6 weeks (Tx > 6 weeks) before the first immunization event. In 46 patients given a 2-dose vaccination series, the percentage of good antibody and good T-cell responders was 39.3% and 73.7% in patients with Tx < 6 weeks and 94.4% and 100% in patients with Tx > 6 weeks, respectively. An additional 3rd vaccination in 16 patients with Tx < 6 weeks, increased the percentage of good antibody responders to 70% with no change in T-cell response. A 3-dose vaccination series effectively boosted antibody levels and is of value for patients undergoing active cancer treatment.

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SARS-CoV-2 vaccine-induced humoral and cellular immunity in patients with hematologic malignancies

Cited by 8 publications

References 67 publications

Initial Efficacy of the COVID-19 mRNA Vaccine Booster and Subsequent Breakthrough Omicron Variant Infection in Patients with B-Cell Non-Hodgkin’s Lymphoma: A Single-Center Cohort Study

Initial Efficacy of the COVID-19 mRNA Vaccine Booster and Subsequent Breakthrough Omicron Variant Infection in Patients with B-Cell Non-Hodgkin’s Lymphoma: A Single-Center Cohort Study

Increase in antibody titer and change over time associated with severe acute respiratory syndrome coronavirus 2 infection after mRNA vaccination: Consideration of the significance of additional vaccination

Immune Response following BNT162b2 mRNA COVID-19 Vaccination in Pediatric Cancer Patients

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